37D2195890 CLIA NUMBER - CARESOURCE, LLC

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Laboratory Demographics

CLIA Number: 37D2195890

Facility Name: CARESOURCE, LLC

Facility Address:
1400 SW EXPRESSWAY DR
BROKEN ARROW, OK
ZIP 74012
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Facility Phone Number: 918 250-7051

Facility Type: Other - DME/CPAP PROVIDER

Certificate Type: Waiver

NPI Number: 1013024710

Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies
A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.

CLIA Record

Field Name	Field Value
CLIA Number	37D2195890
LAB Type	Other - DME/CPAP PROVIDER
Facility Name	CARESOURCE, LLC
Street	1400 SW EXPRESSWAY DR
City	BROKEN ARROW
State	OK
ZIP	74012
Phone	918 250-7051
CertificateType	4
CertificateEffectiveDate	10/13/2022
CertificateExpirationDate	10/12/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024